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Athens, December 17, 2025 –   George Kourepis, Director in Deloitte’s Strategy team, presented today at a special Press Conference on behalf of the Hellenic Association of Pharmaceutical Companies, the study “Looking ahead: A roadmap for pharmaceutical policy in Greece”. The study is a follow-up to Deloitte’s 2020 study and aspires to provide a comprehensive roadmap for the transformation of Greece’s pharmaceutical system, aiming to improve sustainability, ensure equal patient access to the treatments they need, and align with international standards. Through a data-driven methodology and broad stakeholder engagement, the study identifies key structural challenges, assesses the existing policy framework, and proposes a set of pragmatic and meaningful reforms to ensure long-term resilience.

The financing of pharmaceutical expenditure in Greece has been trapped in a vicious circle that began with our entry into the memoranda and which leads to a series of paradoxes. Limited demand control perpetuates a cost-inefficient mix, increasing overall spending. At the same time, public funding does not follow the growth rate of total expenditure, leading to increased returns. Given the stable fiscal framework provided by the reimbursement mechanism, the State does not have a strong incentive to promote measures to control the total expenditure.

The paradoxes of the system

Mr. Kourepis, analyzing the paradoxes of the system in our country, said that Greece has the highest levels of returns, while it has one of the lowest prices of originals in Europe. Despite increases in public spending in recent years, reimbursement levels continue to be on an upward trend. While pricing rules across distribution channels are common, there are significant variations in return levels. The costs of social and welfare policies create increased expenditure that is covered by industry. The complexity, finally, is enhanced by the addition of channels and exceptions, in contrast to European trends (2 distribution channels in most countries).

International trends and challenges

At the same time, Greece is currently faced with a number of international challenges, at a time when public funding per capita lags significantly behind comparable markets. From 2020 to 2022, Greece recorded the largest increase in total expenditure (22%) and the smallest increase in public expenditure (5%) in per capita terms, compared to southern and other European countries. Global pressures on innovation and changes in investment priorities, competition between the US, China and Europe, price pressures from the US, etc. pose significant challenges to the sustainability of pharmaceutical innovation that we need to consider.

Looking ahead and balancing the system

In order to balance the system, a twofold objective should be set (containment of total expenditure and increase of public funding) while introducing a co-responsibility mechanism for managing divergences.

First of all, it is necessary to contain the increase in expenditure and for the system to return to a more rational financing, while there should be actions and financial injections to manage the resulting funding gap. If there is no management of the expenditure, it can reach €10.5 billion. by 2028. A gradual redefinition of public investment in medicines is required, at the level of Southern European countries, as, as the Deloitte study shows, the funding gap will amount to €1.5 billion. by 2028, of which €0.8 billion. could concern additional funding and the €0.7 billion. to come from reforms for better control of expenditure.

At the same time, compulsory returns (clawback and rebates) should be reduced. A realistic and achievable goal is to return to ~40% returns, i.e. to the levels of 2020, which was the basis for the Recovery and Resilience Fund.

Finally, if structural measures are not taken and implemented immediately, pharmaceutical expenditure will be driven to unsustainable levels with all the consequences this will have for the industry, but also especially for patients’ access to their treatments.

The proposed reforms are structured around three strategic axes, which together compose a coherent roadmap for the implementation of these reforms:

1. Closing the funding gap
2. Control of expenditure / Implementation of reforms
3. Strengthening primary care and focusing on prevention

The transformation of the pharmaceutical system is necessary to move from a condition in which all participants lose to a value-based system where all stakeholders benefit.

Deloitte Study – Presentation

Deloitte Study – Full Report